Neuropsychiatrie de l''Enfance et de l''Adolescence最新文献

{"title":"La consommation de médicaments psychotropes chez les enfants et les adolescents autistes en France. Analyse des bases du Système national de données de santé sur la période 2010–2022","authors":"S. Ponnou ,&nbsp;X. Briffault ,&nbsp;B. Thomé ,&nbsp;V. Aragno ,&nbsp;B. Chamak","doi":"10.1016/j.neurenf.2025.02.006","DOIUrl":"10.1016/j.neurenf.2025.02.006","url":null,"abstract":"<div><h3>Context</h3><div>Questions regarding the use of psychotropic medications in children and adolescents with autism have drawn significant attention in the scientific literature and public debates at the international level. However, to date, no dedicated epidemiological data are available on this topic in the scientific literature or in information provided by health agencies or public authorities in France. This article aims to analyze data from the National Health Data System (SNDS) to describe trends in psychotropic medication use among children and adolescents with autism between 2010 and 2022, as well as the clinical, demographic, and social factors contributing to these prescriptions.</div></div><div><h3>Methods</h3><div>A systematic analysis was conducted on psychotropic medication use in autistic patients aged 0 to 17 years within the SNDS database (covering 99% of the population residing in France) from 2010 to 2022. The study focused on the following classes of medications: N05A antipsychotics, N05B anxiolytics, N05<!--> <!-->C hypnotics and sedatives, N06A antidepressants, N06B psychostimulants, N03 antiepileptics, and N04 antiparkinsonians.</div></div><div><h3>Results</h3><div>Analysis of the SNDS data revealed a high rate of psychotropic medication use among children and adolescents with autism: 36.8% in 2022, including 26.3% among 0–2-year-olds, 27.8% among 3–5-year-olds, 36.5% among 6–11-year-olds, and 41.7% among 12–17-year-olds. The use of psychotropic medications in autistic patients aged 0 to 17 years remained stable between 2010 (31.8%) and 2019 (31.6%) but increased from 2019 to 2022 (36.8%). However, disparities are observed across treatment subclasses: a decrease in antiepileptics (N03A) (7.5% in 2010 to 3.9% in 2022), antiparkinsonians (N04A) (2.2% in 2010 to 1.2% in 2022), antipsychotics (N05A) (18.6% in 2010 to 16.1% in 2022), and anxiolytics (N05B) (10.2% in 2010 to 8.3% in 2022); and an increase in hypnotics (N05C) (0.7% in 2010 to 15.4% in 2022), antidepressants (N06A) (2.5% in 2010 to 3.8% in 2022), and psychostimulants (N06B) (6.3% in 2010 to 11.9% in 2022). These prescription rates are accompanied by significant consumption volumes, with an average of 18 to 19 boxes per year per child and treatment durations exceeding 10 years. Polypharmacy is prevalent, and associated biological monitoring is insufficient. The social disadvantage rate within this population was 43.5% in 2022.</div></div><div><h3>Discussion</h3><div>The findings are discussed in light of international scientific consensus, recommendations from health agencies, and contemporary initiatives focusing on deprescription practices in autism care for children and adolescents. Further research is needed to explore the potential adverse effects of these medications, the clinical reasons for their prescriptions, and the most suitable therapeutic strategies for autistic children.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 4","pages":"Pages 205-216"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agenda","authors":"","doi":"10.1016/j.neurenf.2025.05.003","DOIUrl":"10.1016/j.neurenf.2025.05.003","url":null,"abstract":"","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 4","pages":"Pages 234-236"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"","authors":"N. Rabain","doi":"10.1016/j.neurenf.2025.04.003","DOIUrl":"10.1016/j.neurenf.2025.04.003","url":null,"abstract":"","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 4","pages":"Pages 232-233"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"« L’autisme profond » : une casuistique pour le clinicien","authors":"R. Pry ,&nbsp;A. El Achhab","doi":"10.1016/j.neurenf.2025.03.007","DOIUrl":"10.1016/j.neurenf.2025.03.007","url":null,"abstract":"<div><div>The introduction by the Lancet Commission in 2022 of the notion of “profound” autism raised a number of questions, mainly concerning its definition and the proposed criteria. Between advocates of neurodiversity and “frank” autism on the one hand, and families faced with complex situations in which their child is severely mentally handicapped and requires day-to-day care on the other, the search for a consensus has been difficult, even if the notion of “spectrum” could have appeared as a solution.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 4","pages":"Pages 226-231"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"« Un chat dans la gorge » : comprendre le langage figuré quand on est autiste","authors":"J. Hattouti","doi":"10.1016/j.neurenf.2025.03.002","DOIUrl":"10.1016/j.neurenf.2025.03.002","url":null,"abstract":"<div><div>In the autism spectrum disorder, difficulties in understanding figurative language have been widely documented in the scientific literature. This review aims to examine the state of current knowledge by focusing specifically on the understanding of idiomatic expressions. Due to their semantic opacity and conventional nature, these expressions cannot be understood from the sole literal meaning of the words that compose them. This review explores the information processing strategies favored by autistic people to understand idioms and put them into perspective with the underlying cognitive mechanisms, including central coherence, executive functions and theory of mind. What should be retained from this synthesis is that the understanding of idiomatic expressions in individuals with autism relies on a complex interaction between their linguistic abilities and their capacity to integrate contextual information, a process influenced by their cognitive particularities. Finally, the interest of integrating these tasks into clinical assessments is discussed to refine the analysis of pragmatic skills and to propose educational and therapeutic interventions targeting the improvement of the use of context and inference strategies.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 4","pages":"Pages 217-225"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospitalisations de post-urgence pédopsychiatriques en service de pédiatrie : état des lieux à l’hôpital des enfants de Toulouse","authors":"M. Chardac ,&nbsp;A. Revet ,&nbsp;J.-P. Raynaud ,&nbsp;G. Benvegnu","doi":"10.1016/j.neurenf.2025.03.008","DOIUrl":"10.1016/j.neurenf.2025.03.008","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to analyze the characteristics of children hospitalized for psychiatric reasons in the context of increasing demand and limited resources.</div></div><div><h3>Patients and methods</h3><div>A retrospective, single-center observational study was conducted using hospitalization data from August 2020 to August 2022. Participants included children under 15 years old hospitalized for psychiatric reasons.</div></div><div><h3>Results</h3><div>The study included 764 hospitalizations, with an average age of 13.3 years, of whom 73.3% were female. The average length of hospitalization was 4.6 days. Suicide crises accounted for 73.8% of the hospitalization reasons. Approximately 14% of all stays led to referral to a child pediatric psychiatry service inpatient unit.</div></div><div><h3>Discussion</h3><div>A strength of this study is the completeness of its data. Its limitations include the single-center design and lack of prior data. Subgroups, such as those under social or judicial measures, highlight the need for collaboration with social partners. The increase in referrals and the challenges of guiding prepubertal populations underscore the need for expanded child psychiatry resources, both inpatient and outpatient.</div></div><div><h3>Conclusion</h3><div>This single-center study highlights most hospitalizations for suicidal crises in young female patients with complex care pathways. It emphasizes the need for a reasoned strengthening of child psychiatric care and calls for further multicenter studies to better understand the national situation.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 8","pages":"Pages 409-418"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145527851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’alliance thérapeutique en situation transculturelle. Enquête auprès des psychiatres de l’enfant et de l’adolescent de la Haute-Garonne et perspectives","authors":"D. Boisson ,&nbsp;I. Gicquel ,&nbsp;F. Giraud ,&nbsp;M.-R. Moro","doi":"10.1016/j.neurenf.2024.11.004","DOIUrl":"10.1016/j.neurenf.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>The problem of the therapeutic alliance seems very present and specific in child psychiatry in a transcultural situation. The purpose of this article is to make an inventory of the practices and uses of child psychiatrists in Haute-Garonne when they are confronted with a lack of therapeutic alliance in a transcultural situation. Then, in a second step, to propose avenues for the evolution of practices based on the theoretical developments proposed by the transcultural current developed by Marie Rose Moro, with the aim of improving the therapeutic alliance and therefore the efficiency of care provided to migrant populations.</div></div><div><h3>Method</h3><div>Twenty-nine psychiatrists out of 58 responded to a questionnaire asking to describe, in a quantitative and qualitative way, the clinical practices with patients from first and second generation migration on the theme of the alliance, its identification, its remediation in the event of default, recourse to interpreters, recourse to specific transcultural or intercultural mechanisms, interest in transcultural concepts, as well as proposals for improving practices.</div></div><div><h3>Results</h3><div>The results show that the child psychiatrists of Haute-Garonne are generally aware of and interested in the concepts of transcultural psychiatry but that few of them use specific devices which are also few in the territory. The alliance problems encountered are not always related to the cultural particularities of the families. They do not always recognize the importance of interpreters in their functions as “cultural mediators” but more for the translation of the language. Many proposals are emerging to improve practices and resources in the territory.</div></div><div><h3>Conclusions</h3><div>From these results, avenues for development have emerged at several levels: adapting existing systems through better knowledge and taking into account the cultural specificities of patients, developing knowledge and the use of interpreting as well as to supervisions, set up new specific mechanisms (such as consultation and transcultural mediation) with trained practitioners and organize a network allowing greater clarity and better access to the resources of the territory.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 3","pages":"Pages 145-155"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expérimentations d’usage de substances psychoactives et pratiques addictives chez les jeunes adultes","authors":"A. Bezo ,&nbsp;A. Benyamina ,&nbsp;S. Coscas ,&nbsp;L. Karila","doi":"10.1016/j.neurenf.2025.01.008","DOIUrl":"10.1016/j.neurenf.2025.01.008","url":null,"abstract":"<div><div>The terms new substances and new behaviors refer to the current practices of young adults in a broad spectrum from recreational use to authentic addictive disorders. Trends have evolved as much in their intensity of consumption as in their uses.</div></div><div><h3>Method</h3><div>The purpose of this review is to describe current practices among young adults. A literature review was conducted between 2008 and 2024 on the websites PubMed, Google Scholar.</div></div><div><h3>Results</h3><div>We reviewed several substances and associated behaviors namely; nitrous oxide, poppers, cannabis, cannabinoids, tobacco and related products, and finally the misuse of codeine syrup. Although levels of substance use have generally decreased among young adults, the substances described constitute major public health issues. Indeed, their danger, although little known and trivialized by young people, is considerable. Although the mechanisms of action differ from one molecule to another, the substances described are all at risk of abuse and addiction. The use of these substances exposes one to the risk of physical and psychological complications.</div></div><div><h3>Conclusion</h3><div>The evolution of practices and the emergence of new products imply changes, both in the choice of prevention measures and in the consumption practices of users. Information for professionals and users is therefore essential to prevent and reduce the risk of harm from these substances.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 3","pages":"Pages 163-169"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agenda","authors":"","doi":"10.1016/j.neurenf.2025.04.001","DOIUrl":"10.1016/j.neurenf.2025.04.001","url":null,"abstract":"","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 3","pages":"Pages 170-172"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description et intérêt d’un dispositif collaboratif multidisciplinaire pour améliorer les pratiques de prescriptions médicamenteuses en hôpital de jour pour adolescents","authors":"A. Laporte ,&nbsp;A. Chaupin ,&nbsp;T. Lanot","doi":"10.1016/j.neurenf.2025.02.007","DOIUrl":"10.1016/j.neurenf.2025.02.007","url":null,"abstract":"<div><div>A quantitative assessment of drug prescriptions was carried out in a day hospital for adolescents following several cases of drug iatrogenia and lack of therapeutic response to treatment. These data – which are consistent with the literature on the frequency, age of introduction and off-label prescribing in child psychiatry – prompted the unit to set up a working group in 2020 to monitor drug prescriptions, including the pharmacy and the pharmacokinetics laboratory at the hospital and university centre. The main aim of this work was to highlight the improvements in how adolescents are treated for drug-related problems, thanks to this multidisciplinary approach, in terms of the improvements proposed and the resulting clinical benefits. In practice, a meeting was organised every six months at the day hospital to discuss one or two complex situations. The doctor and nurses described the clinical context and explained the difficulties. The pharmacist carried out a drug history and an in-depth analysis of the prescription and provided information on good practice. The biologist analysed the results of plasma pharmacological assays and made recommendations. A review of the literature could also have been carried out. The doctor recorded these discussions in the patient file and involved the teenager and his or her legal representatives in the conclusions of the meeting and the resulting therapeutic choices. This decision-making aid means that a specific, collegial period of reflection can be devoted to drug prescribing, and it provides a better framework for therapeutic strategies, especially outside the scope of marketing authorization. Abnormalities in the metabolism of psychotropic drugs have been identified. This meeting can also contribute to the development of new skills. We propose to highlight how this working method helps to improve the quality, effectiveness and safety of drug prescribing.</div></div>","PeriodicalId":39666,"journal":{"name":"Neuropsychiatrie de l''Enfance et de l''Adolescence","volume":"73 3","pages":"Pages 125-132"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}